Provider Demographics
NPI:1629017736
Name:PRIDGEN, WILLIAM LANGLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LANGLEY
Last Name:PRIDGEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1837 COMMONS NORTH DR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-3700
Mailing Address - Country:US
Mailing Address - Phone:205-366-0696
Mailing Address - Fax:205-366-1451
Practice Address - Street 1:1837 COMMONS NORTH DR
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-3700
Practice Address - Country:US
Practice Address - Phone:205-366-0696
Practice Address - Fax:205-366-1451
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2016-08-18
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Provider Licenses
StateLicense IDTaxonomies
AL00022573208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51098967OtherBLUE CROSS AND BLUE SHIELD OF ALABAMA
AL1629017736Medicaid
AL1629017736Medicaid
AL1629017736Medicaid